Individual
MS. PEGGY STATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2033 MEADOWVIEW LN, STE 200, KINGSPORT, TN 37660-7569
(423) 857-2260
(423) 857-2261
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN5238
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010118042
—
VA
05
—
3908271
—
TN
05
—
3908279
—
TN
Enumeration date
05/24/2005
Last updated
09/23/2009
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